State of Illinois
92nd General Assembly
Legislation

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92_HB0757

 
                                               LRB9204895DJgc

 1        AN ACT in relation to aging.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The  Senior  Citizens  and  Disabled  Persons
 5    Property  Tax  Relief  and  Pharmaceutical  Assistance Act is
 6    amended by changing the title of the Act,  changing  Sections
 7    1,  5,  6,  7,  8,  8a,  9, and 12, and adding Section 4.5 as
 8    follows:

 9        (320 ILCS 25/Act title)
10        An  Act  in  relation  to  the  payment  of  grants   and
11    allowances  to enable the elderly and the disabled to acquire
12    or retain private housing, and to acquire prescription drugs,
13    and to obtain long-term care.

14        (320 ILCS 25/1) (from Ch. 67 1/2, par. 401)
15        Sec. 1.  Short title. This Article shall be known and may
16    be  cited  as  the  "Senior  Citizens  and  Disabled  Persons
17    Property Tax Relief and Pharmaceutical  Assistance  Act".  As
18    used in this Article, "this Act" means this Article.
19    (Source: P.A. 83-1531.)

20        (320 ILCS 25/4.5 new)
21        Sec. 4.5.  Long-term care allowance.
22        (a)  In  this  Section,  "eligible  individual"  means an
23    individual who meets the following criteria:
24             (1) The individual is 65 years of age or older or is
25        a disabled person as defined in this Act.
26             (2) The individual  is  a  resident  in  a  facility
27        licensed under the Nursing Home Care Act.
28             (3)  The  individual does not have sufficient income
29        or assets to pay for his or her  sheltered  care  in  the
 
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 1        facility  (as  defined in the Nursing Home Care Act), and
 2        that care  is  paid  for  entirely  by  a  child  of  the
 3        individual.
 4             (4)  The  individual  does not qualify for any other
 5        governmental financial assistance that would pay for  any
 6        portion of his or her sheltered care in the facility.
 7        (b)  The  Department  shall  establish  and  administer a
 8    long-term care allowance program as provided in this Section.
 9    An  eligible  individual,   or   an   eligible   individual's
10    representative,  may apply to the Department for an allowance
11    under this Section in the form and manner prescribed  by  the
12    Department  by  rule.   The  Department  shall adopt rules to
13    establish   procedures   for   verifying   an    individual's
14    eligibility for an allowance under this Section, to establish
15    an  individual's  period  of  eligibility,  and  to otherwise
16    administer the program.
17        (c) The Department shall award a monthly  long-term  care
18    allowance  to  each  eligible  individual who applies for the
19    allowance.  The Department shall determine the amount of  the
20    allowance,  based  on  a percentage of the amount paid by the
21    individual's child for the individual's sheltered care.   The
22    Department  shall  adopt rules establishing the amounts to be
23    paid as allowances under this Section.
24        (d) An individual who receives an  allowance  under  this
25    Section must use the allowance to pay for a portion of his or
26    her sheltered care.

27        (320 ILCS 25/5) (from Ch. 67 1/2, par. 405)
28        Sec. 5.  Procedure.
29        (a)  In  general.   Claims must be filed after January 1,
30    on forms prescribed by the Department.  No claim may be filed
31    more than one year after December 31 of the  year  for  which
32    the  claim  is filed except that claims for 1976 may be filed
33    until  December  31,  1978.   The  pharmaceutical  assistance
 
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 1    identification card provided for in subsection (f) of Section
 2    4 shall be valid for a period not to exceed one year.
 3        (b)  Claim is Personal.  The right to file a claim  under
 4    this  Act  shall  be  personal  to the claimant and shall not
 5    survive his death, but such right may be exercised on  behalf
 6    of  a claimant by his legal guardian or attorney-in-fact.  If
 7    a claimant dies after having filed a timely claim, the amount
 8    thereof shall be disbursed to his surviving spouse or, if  no
 9    spouse survives, to his surviving dependent minor children in
10    equal  parts,  provided  the spouse or child, as the case may
11    be, resided with the claimant at the time he filed his claim.
12    If at the time of disbursement neither the claimant  nor  his
13    spouse  is  surviving, and no dependent minor children of the
14    claimant are surviving the amount of the claim shall  escheat
15    to the State.
16        (c)  One  claim  per  household.   Only  one  member of a
17    household may file a claim under this  Act  in  any  calendar
18    year;  where  both  members  of  a  household  are  otherwise
19    entitled  to claim a grant under this Act, they must agree as
20    to which of them will file a claim for that year.
21        (d)  Content of application form.  The form prescribed by
22    the Department for purposes of paragraph (a) shall include  a
23    table,  appropriately keyed to the parts of the form on which
24    the claimant is required to furnish information,  which  will
25    enable  the  claimant  to  determine  readily the approximate
26    amount of grant to which he is entitled by relating levels of
27    household  income  to  property   taxes   accrued   or   rent
28    constituting property taxes accrued.
29        (e)  Pharmaceutical     Assistance    Procedures.     The
30    Department  shall  establish  the   form   and   manner   for
31    application,  and establish by January 1, 1986 a procedure to
32    enable persons to apply for the additional grant or  for  the
33    pharmaceutical  assistance  identification  card  on the same
34    application form. The Department shall determine  eligibility
 
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 1    for  pharmaceutical  assistance using the applicant's current
 2    income. The Department shall  determine  a  person's  current
 3    income in the manner provided by the Department by rule.
 4        (f)  Long-term  care  allowance.   The  Department  shall
 5    adopt  rules  to  establish the procedures for applying for a
 6    long-term care allowance under Section 4.5.
 7    (Source: P.A. 91-533, eff. 8-13-99; 91-699, eff. 1-1-01.)

 8        (320 ILCS 25/6) (from Ch. 67 1/2, par. 406)
 9        Sec. 6.  Administration.
10        (a)  In general.  Upon receipt of a timely  filed  claim,
11    the  Department  shall  determine  whether  the claimant is a
12    person entitled to a grant under this Act and the  amount  of
13    grant  to which he is entitled under this Act. The Department
14    may require the claimant to furnish reasonable proof  of  the
15    statements of domicile, household income, rent paid, property
16    taxes  accrued  and  other  matters  on  which entitlement is
17    based, and  may  withhold  payment  of  a  grant  until  such
18    additional proof is furnished.
19        (b)  Rental  determination.  If the Department finds that
20    the gross rent used in the computation by a claimant of  rent
21    constituting  property  taxes accrued exceeds the fair rental
22    value for the right to occupy that residence, the  Department
23    may  determine  the  fair rental value for that residence and
24    recompute   rent   constituting   property   taxes    accrued
25    accordingly.
26        (c)  Fraudulent claims.  The Department shall deny claims
27    which  have  been fraudulently prepared or when it finds that
28    the claimant has acquired title to his residence or has  paid
29    rent for his residence primarily for the purpose of receiving
30    a grant under this Act.
31        (d)  Pharmaceutical  Assistance.     The Department shall
32    allow all pharmacies licensed under the Pharmacy Practice Act
33    to participate as authorized pharmacies unless they have been
 
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 1    removed from that status for cause pursuant to the  terms  of
 2    this  Section.  The Director of the Department may enter into
 3    a written contract with any State agency, instrumentality  or
 4    political  subdivision,  or  a  fiscal  intermediary  for the
 5    purpose of  making  payments  to  authorized  pharmacies  for
 6    covered  prescription  drugs  and coordinating the program of
 7    pharmaceutical assistance established by this Act with  other
 8    programs that provide payment for covered prescription drugs.
 9    Such   agreement  shall  establish  procedures  for  properly
10    contracting for pharmacy services,  validating  reimbursement
11    claims,  validating compliance of dispensing pharmacists with
12    the contracts for participation required under this  Section,
13    validating  the  reasonable  costs  of  covered  prescription
14    drugs,    and   otherwise   providing   for   the   effective
15    administration of this Act.
16        The Department shall promulgate rules and regulations  to
17    implement   and  administer  the  program  of  pharmaceutical
18    assistance required by this  Act,  which  shall  include  the
19    following:
20             (1)  Execution   of  contracts  with  pharmacies  to
21        dispense covered prescription drugs. Such contracts shall
22        stipulate terms and conditions for authorized  pharmacies
23        participation  and  the  rights of the State to terminate
24        such participation for breach of  such  contract  or  for
25        violation of this Act or related rules and regulations of
26        the Department;
27             (2)  Establishment  of maximum limits on the size of
28        prescriptions, new or refilled, which shall be in amounts
29        sufficient for 34 days, except as otherwise specified  by
30        rule for medical or utilization control reasons;
31             (3)  Establishment  of liens upon any and all causes
32        of action which accrue to a beneficiary as  a  result  of
33        injuries   for   which  covered  prescription  drugs  are
34        directly  or  indirectly  required  and  for  which   the
 
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 1        Director  made  payment  or  became liable for under this
 2        Act;
 3             (4)  Charge or collection  of  payments  from  third
 4        parties  or  private  plans  of assistance, or from other
 5        programs of public  assistance  for  any  claim  that  is
 6        properly  chargeable  under  the  assignment  of benefits
 7        executed by beneficiaries as a requirement of eligibility
 8        for the  pharmaceutical  assistance  identification  card
 9        under this Act;
10             (5)  Inspection  of appropriate records and audit of
11        participating authorized pharmacies  to  ensure  contract
12        compliance,  and to determine any fraudulent transactions
13        or practices under this Act;
14             (6)  Annual determination of the reasonable costs of
15        covered prescription drugs for which  payments  are  made
16        under this Act, as provided in Section 3.16;
17             (7)  Payment   to   pharmacies  under  this  Act  in
18        accordance with the State Prompt Payment Act.
19        The Department shall annually report to the Governor  and
20    the  General  Assembly  by  March  1st  of  each  year on the
21    administration of pharmaceutical assistance under  this  Act.
22    By  the  effective  date  of  this  Act  the Department shall
23    determine the reasonable costs of covered prescription  drugs
24    in accordance with Section 3.16 of this Act.
25        (e)  Long-term  care  allowance.   The  Department  shall
26    adopt  rules  to  administer  the  long-term  care  allowance
27    program under Section 4.5.
28    (Source: P.A. 91-357, eff. 7-29-99.)

29        (320 ILCS 25/7) (from Ch. 67 1/2, par. 407)
30        Sec. 7.  Payment and denial of claims.
31        (a) In general. The Director shall order the payment from
32    appropriations  made for that purpose of grants and long-term
33    care allowances to claimants under this Act in the amounts to
 
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 1    which  the  Department  has  determined  they  are  entitled,
 2    respectively. If a claim is denied, the Director shall  cause
 3    written notice of that denial and the reasons for that denial
 4    to be sent to the claimant.
 5        (b)  Payment  of  claims  one dollar and under. Where the
 6    amount of the grant computed under Section 4 is less than one
 7    dollar, the Department shall pay to the claimant one dollar.
 8        (c)  Right to  appeal.  Any  claimant  aggrieved  by  the
 9    action  of  the  Department  under  this  Act, whether in the
10    reduction of the  amount  of  the  grant  or  long-term  care
11    allowance  claimed or in the denial of the claim, may request
12    in  writing  that  the  Department   reconsider   its   prior
13    determination, setting out the facts on which his  request is
14    based.  The  Department shall consider the request and either
15    modify or affirm its prior determination.
16        (d)  Administrative   review.   The   decision   of   the
17    Department to affirm its prior determination, or the  failure
18    of  the  Department  to  act on a request for reconsideration
19    within 60 days, is a final administrative decision  which  is
20    subject  to  judicial  review under the Administrative Review
21    Law, and all amendments and  modifications  thereof  and  the
22    rules  adopted thereto. The term "administrative decision" is
23    defined as in Section 3-101 of the Code of Civil Procedure.
24    (Source: P.A. 82-783.)

25        (320 ILCS 25/8) (from Ch. 67 1/2, par. 408)
26        Sec. 8. Records. Every claimant of a grant  or  long-term
27    care allowance under this Act shall keep such records, render
28    such  statements,  file such forms and comply with such rules
29    and regulations as the  Department  may  from  time  to  time
30    prescribe.   The   Department   may  by  regulations  require
31    landlords to furnish to tenants statements as to  gross  rent
32    or rent constituting property taxes accrued.
33    (Source: P.A. 77-2059.)
 
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 1        (320 ILCS 25/8a) (from Ch. 67 1/2, par. 408.1)
 2        Sec. 8a. Confidentiality.
 3        (a)  Except   as  otherwise  provided  in  this  Act  all
 4    information received by  the  Department  from  claims  filed
 5    under this Act, or from any investigation conducted under the
 6    provisions  of  this  Act,  shall be confidential, except for
 7    official  purposes  within  the  Department  or  pursuant  to
 8    official procedures  for  collection  of  any  State  tax  or
 9    enforcement  of  any  civil  or  criminal penalty or sanction
10    imposed by this Act or by any statute imposing a  State  tax,
11    and  any  person  who  divulges  any  such information in any
12    manner, except for such purposes and pursuant to order of the
13    Director or in accordance with a proper judicial order, shall
14    be guilty of a Class A misdemeanor.
15        (b)  Nothing contained in  this  Act  shall  prevent  the
16    Director  from  publishing  or  making  available  reasonable
17    statistics   concerning   the  operation  of  the  grant  and
18    long-term care  allowance  programs  contained  in  this  Act
19    wherein the contents of claims are grouped into aggregates in
20    such a way that information contained in any individual claim
21    shall not be disclosed.
22        (c)  The  Department  shall  furnish  to the Secretary of
23    State such information as is  reasonably  necessary  for  the
24    administration  of reduced vehicle registration fees pursuant
25    to Section 3-806.3 of "The Illinois Vehicle Code".
26    (Source: P.A. 89-399, eff. 8-20-95.)

27        (320 ILCS 25/9) (from Ch. 67 1/2, par. 409)
28        Sec. 9.  Any person who files a fraudulent  claim  for  a
29    grant  or long-term care allowance under this Act, or who for
30    compensation prepares a claim for a grant or  long-term  care
31    allowance  and  knowingly enters false information on a claim
32    form for any claimant under this  Act,  or  who  fraudulently
33    files multiple claim forms, or who fraudulently states that a
 
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 1    nondisabled  person is disabled, or who fraudulently procures
 2    a  pharmaceutical  assistance  identification  card,  or  who
 3    fraudulently uses such card to procure  covered  prescription
 4    drugs,  or  who, on behalf of an authorized pharmacy, files a
 5    fraudulent claim for payment, is guilty of a Class  4  felony
 6    for  the  first offense and is guilty of a Class 3 felony for
 7    each subsequent offense.  The  Department  shall  immediately
 8    suspend    the   use   of   the   pharmaceutical   assistance
 9    identification card of any  person  suspected  of  fraudulent
10    procurement  or fraudulent use of such card, and shall revoke
11    such card upon a conviction.   A  person  convicted  of  such
12    fraud  shall  be  permanently  barred  from  the  program  of
13    pharmaceutical  assistance  established  under  this Act. The
14    Department  may  recover  from  a  claimant,   including   an
15    authorized  pharmacy,  any  amount  paid  under  this  Act on
16    account of an erroneous or fraudulent claim, together with 6%
17    interest per year. A prosecution  for  a  violation  of  this
18    Section  may  be  commenced at any time within 3 years of the
19    commission of that violation.
20    (Source: P.A. 85-299.)

21        (320 ILCS 25/12) (from Ch. 67 1/2, par. 412)
22        Sec. 12. Regulations - Department on Aging.
23        (a)  Regulations.  The  Director  shall  promulgate  such
24    regulations as are necessary or desirable to  effectuate  the
25    purposes of this Act, including but not limited to the method
26    of computing "gross rent" in the case of a claimant living in
27    a nursing or sheltered care home.
28        (b)  The  Department  on  Aging  shall,  to the extent of
29    appropriations made for that purpose:
30             (1)  attempt   to   secure   the   cooperation    of
31        appropriate federal, State and local agencies in securing
32        the  names  and  addresses  of  persons  to whom this Act
33        pertains;
 
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 1             (2)  prepare a mailing list of persons eligible  for
 2        grants or long-term care allowances under this Act;
 3             (3)  secure  the  cooperation  of  the Department of
 4        Revenue  and  of   local   business   establishments   to
 5        facilitate  distribution  of application forms under this
 6        Act to those eligible to file claims; and
 7             (4)  through   use   of   direct   mail,   newspaper
 8        advertisements and radio and  television  advertisements,
 9        and all other appropriate means of communication, conduct
10        an   on-going   public   relations  program  to  increase
11        awareness  of  eligible  citizens  of  the   grants   and
12        long-term   care   allowances  under  this  Act  and  the
13        procedures for applying for them.
14    (Source: P.A. 78-1249.)

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